| NPI | 1346227758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 20A8178) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME DO3813) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 04428) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2025-05-01 |